OBJECTIVE: The purpose of this study was to evaluate the efficacy and effect of various cryopreservation method on the survival and the cytoskeletal stability of metaphase II mouse oocyte. METHODS: Mouse ovulated oocytes were collected and cryopreserved by a modified slow-freezing method with 1.5 M 1,2-propanediol (PrOH)+0.1 M sucrose or by vitrification using cryo loop and EM grid with 40% ethylene glycol+0.6 M sucrose. Four hours after thawing, intact oocytes were fixed and stained with fluorescein isothiocyanate (FITC)-conjugated monoclonal anti-beta-tubulin antibody to visualize spindle and propidium iodide (PI) to visualize chromosome. Spindle morphology was classified as follows: normal (barrel-shaped), slightly and absolute abnormal (multipolar or absent). RESULTS: Survival rate of the frozen-thawed oocytes in vitrification group was significantly higher than that of slow-freezing group (62.7% vs. 24.4%, p<0.01). Vitrification with cryo loop showed significantly higher survival rate than that with EM grid (67.7% vs. 53.5%, p<0.05). On the other hand, proportion of normal spindle and chromosome configurations of the frozen-thawed oocytes between two vitrification group was not significantly different. CONCLUSION: For mouse ovulated oocytes, vitrification with cryo loop may be a preferable procedure compared to slow-freezing method. Further study should be needed to investigate developmental competency of frozen-thawed mouse oocytes.
Animals ; Cryopreservation* ; Fluorescein ; Hand ; Metaphase ; Mice* ; Oocytes* ; Propidium ; Propylene Glycol ; Sucrose ; Survival Rate ; Vitrification

BACKGROUND AND OBJECTIVES: About one third of all people experience tinnitus in their life. And insomnia is the second most common symptom in tinnitus patients, following hearing disturbance. The aim of this study was to define the influence of insomnia on the clinical features of tinnitus patients and to assess the relation of tinnitus to insomnia and depression. SUBJECTS AND METHOD: The consecutive 197 patients with tinnitus were enrolled from May 2012 to May 2013 for this study. All patients with tinnitus filled out the following questionnaire, Visual Analogue Scale, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI) for evaluating clinical features of tinnitus patients. Also we examined pure tone audiometry and tinnitogram for evaluating audiologic characteristics. RESULTS: When the insomnia was defined as more than five scores in PSQI, 46 of 197 patients had insomnia. Loudness of tinnitus was significantly higher in the tinnitus patients with insomnia group when compared to those of the tinnitus without insomnia group (p=0.018). The score of THI and BDI were significantly higher in the tinnitus with insomnia group, too (p=0.003, <0.001, respectively). A strong correlation (r=0.616, p<0.001) was shown between THI score and BDI score in both groups. CONCLUSION: It appears, due to the high possibility that depression and insomnia are related in tinnitus patients with insomnia, that proper evaluations about sleep disturbance and depression of tinnitus patients are necessary to produce better therapeutic results.
Audiometry ; Depression* ; Hearing ; Humans ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders* ; Tinnitus*

OBJECTIVES: The purpose of this study was to develop the Korean version of the Social Adjustment Scale II-Revised Version (KSAS II-RV) in the schizophrenics. METHODS: KSAS II-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. RESULTS: Data analysis showed statistically significant reliabilities and validities of KSAS II-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS II-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS II-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS II-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS II-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. CONCLUSION: KSAS II-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.
Humans ; Reproducibility of Results* ; Schizophrenia ; Social Adjustment* ; Statistics as Topic

We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Chest Tubes ; Chylothorax* ; Drainage ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Parturition ; Pleural Effusion ; Thorax ; Ultrasonography

PURPOSE: The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. MATERIALS AND METHODS: In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. RESULTS: The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. CONCLUSIONS: We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery.
Critical Pathways ; Gastrectomy ; Humans ; Multivariate Analysis ; Retrospective Studies ; Stomach Neoplasms

A 41-year-old female was admitted for a subcapsular hematoma of her graft kidney six weeks after she underwent a kidney transplant. No report on subcapsular hematomas of graft kidneys has been published in Korea. Subcapsular hematoma of graft kidneys is one of a few very rare causes of bleeding. The clinical manifestations of subcapsular hematoma are the abrupt onset of flank pain or upper abdominal pain, nausea, anorexia, dizziness, and decrease in hemoglobin. If it is diagnosed late, it can result in renal insufficiency, hypovolemic shock, and even death. During the authors' management of a subcapsular hematoma of a renal graft, pure red cell aplasia induced by the parvovirus B19 was found to coexist. Bone marrow suppression, immunosuppressants and other drugs, bleeding, iron deficiency, and renal graft function insufficiency can result in anemia after a kidney transplant. Even though pure red cell aplasia is a rare cause of anemia, it should not be forgotten that pure red cell aplasia induced by parvovirus B19 infection can cause anemia after a kidney transplant.
Abdominal Pain ; Adult ; Anemia ; Anorexia ; Bone Marrow ; Dizziness ; Female ; Flank Pain ; Hematoma ; Hemoglobins ; Hemorrhage ; Humans ; Immunosuppressive Agents ; Iron ; Kidney ; Kidney Transplantation ; Korea ; Nausea ; Parvovirus ; Red-Cell Aplasia, Pure ; Renal Insufficiency ; Shock ; Transplants

OBJECTIVE: The aim of this study was to compare and analyze the effectiveness of different regimens in the treatment of malignant gestational trohphoblastic disease from 1981 to 2001. MATERIALS AND METHODS: This study included 307 patients with malignant gestational trophoblastic disease, who were admitted in Chonnam National University Hospital from 1981 to 2001. Remission rate, remission induction period, toxicity of chemotherapeutic agents depending on risk group and stages were analyzed. RESULTS: While stage I and II showed 100% of remission rate, stage III and IV showed 99.2%, 64.7% of remission rate respectively, resulting in 99.7% of overall remission rate. From 1981 to 1988, average number of cycle and periods for complete remission were 3.4 cycles and 80.3 days for low risk GTT, 6.2 cycles and 144.8 days for high risk GTT. From 1989 to 2001, average number of cycle and remission induction period were 4.1 cycles and 69.9 days, 5.3 cycles and 88.9 days, 6.6 cycles and 162.2 days for low, middle, and high risk GTT, respectively. As adjuvant therapy, 3 cases of hysterectomy and 2 cases of lobectomy were done. And radiation therapy was done on 2 cases of lung lesions and 1 cases of brain lesion. Etoposide and Actinomycin D caused less hepatotoxicity than Methotrexate did. EMA regimen shortened the overall period of treatment and caused less side effect, showing effectiveness equivalent to that of EMA CO regimen. With same therapeutic effect, less side effect and shortened administration period, EMA regimen might be able to substitute EMA CO regimen in high risk GTT. However, there should be more clinical trials before confirmation of its superior therapeutic efficacy over EMA CO regimen. CONCLUSION: When chemotherapy combined with adjuvant therapy such as operation and irradiation was done on appropriate patient group, which were selected based on risk factors and stage, it produced higher remission rate. For better therapeutic outcome, there should be further study on early detection technique and therapeutic effect of other chemotherapeutic agents.
Brain ; Dactinomycin ; Drug Therapy ; Etoposide ; Gestational Trophoblastic Disease* ; Humans ; Hysterectomy ; Jeollanam-do ; Lung ; Methotrexate ; Remission Induction ; Risk Factors

OBJECTIVE: Left ventricular (LV) filling pressure can be estimated using echocardiographic measurements, including the ratio of transmitral early peak flow velocity to tissue Doppler mitral annular motion velocity (E/e′) during sinus rhythm. However, non-invasive echocardiographic estimation is complicated in patients with atrial fibrillation (AF). AF is associated with reduced survival in patients with heart failure with preserved LV ejection fraction (LVEF). The aim of this study was to investigate echocardiographic parameters for predicting LV filling pressure and diastolic function in chronic AF patients with preserved LVEF. METHODS: Clinical data, echocardiographic findings, and laboratory data were assessed retrospectively in 90 chronic AF patients with preserved LVEF who underwent diagnostic left-heart catheterization between January 2011 and September 2015. LV end-diastolic pressure (LVEDP) assessment and standard echocardiographic measurements were performed. RESULTS: The E/e′ ratio was significantly correlated with LVEDP (r=0.449, P < 0.001). Receiver operating characteristic analysis defined the optimal cut-off for E/e′ as 13 (sensitivity, 88%; specificity, 67%) to predict elevated LVEDP (>15 mm Hg). E (r=0.463, P < 0.001) and E/propagation velocity (Vp; r=0.471, P < 0.001) were also correlated with LVEDP. E >90 cm/sec predicted elevated LVEDP with a sensitivity of 84% and a specificity of 70%. Also, an E/Vp >1.6 predicted elevated LVEDP with a sensitivity of 80% and a specificity of 72%. CONCLUSION: E >90 cm/sec, E/e′>13 and E/Vp >1.6 were suggestive of elevated LVEDP in these patients. Therefore, E, E/e′, and E/Vp provide significant predictive value for LVEDP in chronic AF with preserved LVEF.
Atrial Fibrillation* ; Catheterization ; Catheters ; Echocardiography* ; Heart Failure ; Humans ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Stroke Volume*

Pelizaeus-Merzbacher disease (PMD) is a X-linked recessive disorder with dysmyelination in central nervous system caused by proteolipid protein 1 (PLP1) gene mutation. We report a case of PMD with PLP1 exon 1 duplication, previously misdiagnosed as cerebral palsy (CP).A 25-year-old male previously diagnosed as CP visited our clinic with progressive weakness and spasticity of bilateral lower limbs. Next generation sequencing revealed hemizygous duplication of exon 1 in PLP1. Additionally, multiplex ligation-dependent probe amplification assay of the patient's mother showed the same mutation, which could finally confirm the diagnosis as PMD. This patient received comprehensive rehabilitation program, and helped the patient to achieve functional improvement. Proper diagnosis and therapeutic plan will be needed for the patients with PMD, before diagnosing CP rashly.

Most discoid menisci are lateral and medial discoid meniscus is very rare. Several articles have reported on bilateral lateral discoid menisci as well as bilateral medial discoid menisci, and a few articles have reported simultaneous medial and lateral discoid menisci in the same knee. Only one case of simultaneous medial and lateral discoid menisci, bilaterally, has been reported. We present another case of a male patient with bilaterally simultaneous medial and lateral discoid menisci, diagnosed with magnetic resonance imaging and arthroscopy. The patient was treated by arthroscopic partial meniscetomy.
Arthroscopy ; Humans ; Knee ; Magnetic Resonance Imaging ; Male